Senior Encounter Data & Risk Adjustment Analyst

Fallon Health; Central Business District (MA); On-site; USD 125,000 - 130,000; Full time

Job summary

Fallon Health is seeking an Information Management Analyst III, Encounter Reporting & Risk Adjustment Support to lead the analysis, validation, reconciliation, and submission of encounter data to the Commonwealth of Massachusetts and other regulatory bodies. This role partners with multiple teams to ensure data completeness and accuracy for reimbursement and reporting.

The position offers mentorship to junior analysts, project leadership, and opportunities to drive continuous improvements in

Qualifications

• College degree in computer science, engineering, management information systems or related discipline.
• 5+ years of healthcare data analytics, encounter reporting, claims reporting, or regulatory reporting.
• 5+ years’ experience with SQL, data analytics, data warehousing, visualization tools, and project requirements elicitation.

Responsibilities

• Lead analysis, validation, reconciliation, and submission of encounter data to the Commonwealth of Massachusetts and regulators.
• Collaborate with Claims, Enrollment, Provider Operations, IT, Compliance, and Risk Adjustment teams to improve data quality and reporting.
• Mentor junior analysts, provide project leadership, and drive continuous improvement in reporting processes.
• Serve as liaison between business teams, IT, vendors, and external agencies and support audits.

Skills

Healthcare data analytics

SQL

Data warehousing

Visualization tools

Project management

Requirements elicitation

Education

CS / Engineering / MIS degree or related

Tools

Data visualization tools

Job description

Fallon Health is seeking an Information Management Analyst III, Encounter Reporting & Risk Adjustment Support to lead the analysis, validation, reconciliation, and submission of encounter data to the Commonwealth of Massachusetts and other regulatory bodies. This role partners with multiple teams to ensure data completeness and accuracy for reimbursement and reporting.

The position offers mentorship to junior analysts, project leadership, and opportunities to drive continuous improvements in